Advertisement

Effects of Different Suture Techniques on Healing of Experimental Colonic Anastomosis

  • B. Zederfeldt
  • H. Jiborn
  • P. Blomquist

Abstract

Anastomotic leakage and dehiscence after gastro-intestinal surgery endanger the life of the patient. The incidence of anastomotic complications is especially high after surgery on the left colon; anastomotic leaks are reported to occur in 2%–7% of colonic anastomoses in general [1–3], and in up to 25% after anterior resections [1, 4]. Goligher et al. [5], using early postoperative contrast enemas, reported an incidence of anastomotic leakage after anterior resections of over 50%. However, most of these leaks were subclinical.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Dunphy JE (1970) The cut gut. Am J Surg 119:1–8PubMedCrossRefGoogle Scholar
  2. 2.
    Debas HT, Thomson FB (1972) A critical review of colectomy with anastomosis. Surg Gynecol Obstet 135:747–752PubMedGoogle Scholar
  3. 3.
    Wilson SM, Beahrs OH (1976) The curative treatment of carcinoma of the sigmoid, rectosigmoid and rectum. Ann Surg 183:556–563PubMedCrossRefGoogle Scholar
  4. 4.
    Morgenstern L, Yamakawa T, Ben-Shoshan M, Lippman H (1972) Anastomotic leakage after low colonic anastomosis. Am J Surg 123:104–109PubMedCrossRefGoogle Scholar
  5. 5.
    Goligher JC, Graham NG, Dombal FT de (1970) Anastomotic dehiscence after anterior resection of rectum and sigmoid. Br J Surg 57:109–118PubMedCrossRefGoogle Scholar
  6. 6.
    Gambee LP, Garnjobst W, Hardwick CE (1956) Ten years’ experience with a single layer anastomosis in colon surgery. Am J Surg 92:222–227PubMedCrossRefGoogle Scholar
  7. 7.
    Bronwell AW, Rutledge R, Dalton ML jr (1967) Single-layer open gastrointestinal anastomosis. Ann Surg 165:925–932PubMedCrossRefGoogle Scholar
  8. 8.
    Orr NW (1969) A single-layer intestinal anastomosis. Br J Surg 56:771–774PubMedCrossRefGoogle Scholar
  9. 9.
    Matheson NA, Irving AD (1975) Single-layer anastomosis after rectosigmoid resection. Br J Surg 62:239–242PubMedCrossRefGoogle Scholar
  10. 10.
    Everett WG (1975) A comparison of one layer and two layer techniques for colorectal anastomosis. Br J Surg 62:135–140PubMedCrossRefGoogle Scholar
  11. 11.
    Goligher JC, Lee PWG, Simpkins KC, Lintott DJ (1977) A controlled comparison of one- and two-layer techniques of suture for high and low colorectal anastomoses. Br J Surg 64:609–614PubMedCrossRefGoogle Scholar
  12. 12.
    Barker K, Graham NG, Mason MC, Dombal FT de, Goligher JC (1971) The relative significance of preoperative oral antibiotics, mechanical bowel preparation and preoperative peritoneal contamination in the avoidance of sepsis after radical surgery for ulcerative colitis and Crohn’s disease of the large bowel. Br J Surg 58:270–273PubMedCrossRefGoogle Scholar
  13. 13.
    Irvin TT, Goligher JC (1973) Aetiology of disruption of intestinal anastomoses. Br J Surg 60:461–464PubMedCrossRefGoogle Scholar
  14. 14.
    Pikkarainen J (1968) The molecular structures of vertebrate skin collagens. Acta Physiol Scand [Suppl] 309Google Scholar
  15. 15.
    Juva K, Prockop DJ (1966) Modified procedure for the assay of H3- or C14-labeled hydroxyproline. Analyt Biochem 14:77–83CrossRefGoogle Scholar
  16. 16.
    Jiborn H, Ahonen J, Zederfeldt B (1978) Healing of experimental colonic anastomoses: the effect of suture technique on collagen concentration in the colonic wall. Am J Surg 135:333–340PubMedCrossRefGoogle Scholar
  17. 17.
    Jiborn H, Ahonen J, Zederfeldt B (1978) Healing of experimental colonic anastomoses: Bursting strength of the colon following left colon resection and anastomosis. Am J Surg 136:587–594PubMedCrossRefGoogle Scholar
  18. 18.
    Jiborn H, Ahonen J, Zederfeldt B (1978) Healing of experimental colonic anastomoses: Breaking strength of the colon following left colon resection and anastomosis. Am J Surg 136:595–599PubMedCrossRefGoogle Scholar
  19. 19.
    Jiborn H, Ahonen J, Lindell B, Zederfeldt B (1979) Cardiac output distribution after left colon anastomosis in the rat. Eur Surg Res 11:134–144PubMedCrossRefGoogle Scholar
  20. 20.
    Jiborn H, Ahonen J, Zederfeldt B (1980) Healing of experimental colonic anastomoses. III. Collagen metabolism in the colon after left colon resection. Am J Surg 139:398–405PubMedCrossRefGoogle Scholar
  21. 21.
    Jiborn H, Ahonen J, Zederfeldt B (1980) Healing of experimental colonic anastomoses. IV. Effect of suture technique on collagen metabolism in the colonic wall. Am J Surg 139:406–413PubMedCrossRefGoogle Scholar
  22. 22.
    Schrock TR, Deveney CW, Dunphy JE (1973) Factors contributing to leakage of colonic anastomoses. Ann Surg 177:513–518PubMedCrossRefGoogle Scholar
  23. 23.
    Halsted WS (1887) Circular suture of the intestine - an experimental study. Am J Med Sci 94:436–461CrossRefGoogle Scholar
  24. 24.
    Cronin K, Jackson DS, Dunphy JE (1968) Changing bursting strength and collagen content of the healing colon. Surg Gynecol Obstet 126:747–753PubMedGoogle Scholar
  25. 25.
    Hawley PR, Faulk WP, Hunt TK, Dunphy JE (1970) Collagenase activity in the gastro-intestinal tract. Br J Surg 57:896–900PubMedCrossRefGoogle Scholar
  26. 26.
    Irvin TT, Hunt TK (1974) Reappraisal of the healing process of anastomosis of the colon. Surg Gynecol Obstet 138:741–746PubMedGoogle Scholar
  27. 27.
    Irvin TT (1976) Collagen metabolism in infected colonic anastomoses. Surg Gynecol Obstet 143:220–224PubMedGoogle Scholar
  28. 28.
    Rosenberg IL, Graham NG, Dombal FT de, Goligher JC (1971) Preparation of the intestine in patients undergoing major largebowel surgery, mainly for neoplasms of the colon and rectum. Br J Surg 58:266–269PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1982

Authors and Affiliations

  • B. Zederfeldt
  • H. Jiborn
  • P. Blomquist
    • 1
  1. 1.Department of SurgeryMalmö General Hospital University of LundMalmöSweden

Personalised recommendations